More heart info for 50+ers

Thought I'd post the article this time instead of just the link. Relative to this article, sometimes it's hard for me to tell the difference between just getting older (aches and pains) and real problems. It helps to know what to look for to differentiate between the two.

Another problem for me is that oftentimes my riding comes in spurts with gaps between. So it becomes difficult to discern body ailments from training issues.

Anyway, here's the article:

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Clark Kent's Stent

By Charles Hall

It's been 4 1/2 weeks since I received my coronary stent, and three weeks and 450 miles since I resumed cycling. I'm riding about 10% faster than before the stent, and logging about 50% more miles a week. Opening my artery didn't turn me into Superman, just a more fit Clark Kent.

My leg strength is pretty good, but I have some ground to make up on endurance and aerobic conditioning. That seems to be where my blockage held me back.

I asked the doctor what I could've done differently to avoid developing the condition. He said not much, aside from getting my cholesterol checked earlier (triglycerides 232 mg/dL, LDL 181, and HDL 43 the week before the stent was inserted).

The doctor also said that acting on my symptoms instead of ignoring them was the critical thing.

If a person is asymptomatic for coronary artery disease, medicine today does not have a simple, definitive test to reveal it. Lots of research is going into understanding the relationships between cholesterol levels, arterial inflammation and artery disease. Someday we'll have better answers.

For now, we need to note symptoms of problems. And during my most recent 3 weeks of riding, I've realized I missed some personal indicators. My body was telling me things I wasn't hearing until it spoke loudly and urgently.

Three things stand out most:

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I can climb again. Two months ago, I would grab for ever lower gears and grind up hills that are now just a training challenge. I'm relearning technique and gear selection, but hills no longer mean suffering.

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Longer rides don't leave me exhausted. My routine includes a nonstop solo ride of 60+ miles once a week. Last year it would leave me worthless for the rest of the day. Now I feel nicely recovered after a shower, a short rest, and some food.

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Riding in the heat doesn't sap my energy. I rode in temperatures in the low 90's (34C) recently. Alabama's summer heat is just not the factor it's been in recent years.

I was oblivious to the deterioration in my physical ability during the past year or 2. The differences since the stent are striking. There has been an immediate and marked improvement in my climbing, recovery and heat tolerance. My experience indicates that these are good barometers of health, and if there's an unexpected and consistent decline in them, an explanation should be sought.

Keeping a cycling diary (long advocated by RBR) can be a way to spot negative trends. By noting how you feel during rides, your times on certain climbs or courses and your recovery, you'll have a way to judge physical performance -- and potentially the state of your heart's health -- as months go by.

I have an appointment with my cardiologist in July. My goal is to be at 1,000 miles (1,600 km) post-stent by then. I'll write another update following his exam and evaluation.

Lots of good points in the article. I have personal experience with this very subject, being through 5 stents and 1 angioplasty since 2006. And as the article reads I am faster and climbing better than ever. My hill climbs used to be in the 12-13mph range, now 15+. Last nights ride, 20.4 miles, 17.2mph average. I had never been able to average more than 15.5mph or so. I'm shooting for 18mph average by the end of the season. Also it's not unusual for me to cruise at 20-23mph for long stretches of flat road. And the best part, I still have jump left at the end of 35-40 mile rides. I used to be spent. This is one soon to be 56'er who's lovin' cycling again.

Thought I'd post the article this time instead of just the link. Relative to this article, sometimes it's hard for me to tell the difference between just getting older (aches and pains) and real problems. It helps to know what to look for to differentiate between the two.

Another problem for me is that oftentimes my riding comes in spurts with gaps between. So it becomes difficult to discern body ailments from training issues.

Anyway, here's the article:

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It's been quite easy to tell the difference between age and other problems. To do that however, you need a far better understanding of the related physiology than you can get on a forum. You also need to experiment to focus-in on the actual cause if it's a tricky one. At 69, the only age related issue that I have or have had, is it takes longer to recover, so it's more important to keep up with the fitness program and to build up slowly when changing performance levels. In other words you lose fitness more quickly and it's easier to over train the older you get.

As long as I don't sluff-off on the weight training, there are literally no aches and pains. Exception of course are crashes on the mountain bike. If I do sluff off-on the weights, the aches and pains will start.

If you do a lot of sitting for a few days rather than staying active, you'll feel it after the next ride. You won't necessarily be slower, but recovering from the ride will take longer.

On the article, the key point here is that doctors are not trained/educated in physical fitness and nutrition. Mine thinks (or used too) that I'm killing myself by running my heart rate above 80% max for up to 75 minutes and actually hitting my max occasionally. He's slowly coming around after a few years of doing a bunch of tests to see if I'm self destructing. He's also bought some books I recommended on the subject.

You can in fact reduce the risk of death by a factor of 5 over a sedentary person with adequate fitness (quantified in one of the books). Consuming less processed food (best would be zero), more plant based food and reducing animal derived food has to help in that regard as well, especially concerning the cardio system. That's in comparison to the typical American fare.

The ageing decay process is now becoming far better understood as are the requirements to counter it. I lucked out and have had a fitness program for about 44 years that comes fairly close to that now recommended to counter that age related decay. We are apparently genetically programmed to start decaying at around age 40.

#1. Physical Activity and Health, edited by Bouchard, Blair & Haskell. Published '07. It's a large book with over 400 pages.

It's a college level text book. List around $80. Got mine used (had a dent on a corner, in essence it was new) for $50. Very readable. Might have to do a google search for a definition once in a while.

This book documents about everything known about physical activity and health effects. The devil is in the details and this has the details. Like any technical, fact-filled book, it will read a little slow in places.

I showed my doctor a few curves in the book on issues he raised about my exercise level and my pending doom. He asked where to get a copy. When he says that, he reads it.

By the way, all these books I got from Amazon.

#2. Younger Next Year by Crowley and Lodge, M.D., Pub '04.

It defines why and how we decay and how to counter the decay. Very profound stuff. Makes a very rigorous case for the need for weight training. I can vouch for the absolute necessity of weight training in addition to aerobics as you get beyond 40.

You can save time and just read the meat which are the chapters written by the M.D. However, I got the most out of it by reading the whole book first, then at a later time studying the chapters written by the M.D.

#3 Spark by Ratey, M. D. and Hagerman. Pub '08. Similar to younger next year, but focuses on the impact of exercise in increasing neural networks in the brain (yes, you do get a bigger brain and can become smarter even as you get old), avoiding ageing effects like dementia and general cognitive decline with age. Very specific on how exercise makes profound changes in you cell structure.

Note #'s 2 & 3 are not how too books. That's the easy part. They are more in quatifying age related decay and what happens when you exercise strenuously enough. Both recommend hart rate monitors.

Spark is particularly poignant to me as last week I learned that two old friends of mine have large areas of their brains destroyed. The doctors have no clue why. One has very little functionality left, the other is still in relatively good shape. He's reading #'s 2 & 3 now. I suspect, he can regain active brain or at least stop the decay and he's going to give it a try I'm sure. He's already working on the aerobics component. Note that neither one was physically active.

>If a person is asymptomatic for coronary artery disease, medicine today does not have a simple, definitive test to reveal it.<

coronary calcium scoring CT evaluates the presence of coronary artery disease (although not the degree of stenosis) and is completely non-invasive and risk free. simple, but maybe not definitive.

contrast coronary CT evaluates the presence of coronary artery disease, the degree of stenosis (in some studies has had equivalent accuracy to cardiac cath), and in some cases can characterize the type of plaque (which coronary cath cannot). this CT involves intravenous "dye" injection which has minimal risk. imo this is both simple, and definitive.

>If a person is asymptomatic for coronary artery disease, medicine today does not have a simple, definitive test to reveal it.<

coronary calcium scoring CT evaluates the presence of coronary artery disease (although not the degree of stenosis) and is completely non-invasive and risk free. simple, but maybe not definitive.

contrast coronary CT evaluates the presence of coronary artery disease, the degree of stenosis (in some studies has had equivalent accuracy to cardiac cath), and in some cases can characterize the type of plaque (which coronary cath cannot). this CT involves intravenous "dye" injection which has minimal risk. imo this is both simple, and definitive.

What role does acoustic imaging play in determining plaque? I recently had a sonogram of my heart and my carotid arteries. It was more to allay my doctors fears concerning my driving my heart rate above 80% max and sometimes max.

Heart info

I found myself continuously nodding my head (not because I was dozing off)while reading the piece.
I've had the E version of COPD for at least 10 years now.
The docs had given my heart a clean bill of health back in 98 after I suffered what I'd thought was a heart attack.
They gave me EVERY test but the angiogram.
The 'attack' was discovered to be bullea(lung related)and so I was quite content that the heartburn/rapid pulse/shortness of breath I was getting on those hill climbs and 20mph charges with the club were lung realted.
Via a back door route, (went in for a pulmonary stress test and a possible heart problem popped up)
Had an angiogram and attempted angioplasty and 3 weeks later (November 3rd.2007) I had double bypass surgery.
I'm not a highly religious guy but someone or something had it's hand in this one.
I'd probably be dead today had I not had the initial stress test for the lungs.
That said: Prior to the surgery, I'd be lucky if I was able to get to 16/17mph or get halfway up a moderate climb before the 'symptoms' would arise and I'd be limping the rest of the ride.
This morning, on a 36 mile (caveat is it was fairly flat)club ride , I stayed with the A groups lead riders at 22/23 mph .
HR never got over 161.
I'll never have the oxygen transfer I need to get much better than the above but....
I can ride home from such a ride and-at65-help my susan with the garden.

What role does acoustic imaging play in determining plaque? I recently had a sonogram of my heart and my carotid arteries. It was more to allay my doctors fears concerning my driving my heart rate above 80% max and sometimes max.

All was pronounced well, but how good of a test is it?

Al

i think you are referring to an echocardiogram. it does not evaluate coronary artery stenosis or plaque.

there is a test called stress echocardiogram that, in my limited understanding, is one method of indirectly evaluating for coronary artery stenosis. other indirect methods are the standard stress test and radionuclide stress imaging.

I think you are referring to an echocardiogram. it does not evaluate coronary artery stenosis or plaque.

there is a test called stress echocardiogram that, in my limited understanding, is one method of indirectly evaluating for coronary artery stenosis. other indirect methods are the standard stress test and radionuclide stress imaging.

I don't know what the medical name is, but it's basically a picture generated with ultrasound; an acoustic real-time image is what it would be called in my profession. I saw my heart beating on the monitor. They do Doppler processing (I assume) and they get an idea of the leakage at the heart valves. The leakage is shown as a different color to the normal blood flow. Some leakage is of course is normal

A specialist analyzed the images (heart and carotids) and pronounced that I had a low level of plaque build up.

I wondered how good it was as it's reasonably priced as far as these things go. Some 11 years ago I had one that missed a prostate cancer, but the biopsy got it a little later. Hopefully, they are a lot better now.

An echocardiogram is very good at showing how well the heart is functioning, how well it is contracting, & moving blood through, and if there is a problem with the muscle contraction, then it might be due to blackage in the arteries. This test can show other function problems, like those that come from high blood pressure or COPD. But it can't "see" actual blockages or plaque.

A stress test relies on the fact that blockages can cause changes on your EKG when you exercise--but it doesn't always. Isotope imaging will show actual defects in blood supply to the heart muscles--but again doesn't show the arteries themselves.

the newest CT scans are the wave of the future--showing arteries & function in real time & multiple dimensions.
But, no test will ever be 100% for sure. Medicine is still a lot of educated guessing.

That lack of energy, fatigue, reduction in stamina--is the most common and most ignored symptom of heart disease--esp. in women.

An interesting point made in the book Spark is that radiation exposure can be beneficial. There was concern about some 45,000 ship yard workers who had been exposed to low-level radiation working on the Navy's nuclear fleet. Some years back, even cruiser's were being built with nuclear propulsion.

The Navy no longer builds cruisers and only new subs and carriers are built with nuke power now.

It turned out that those workers are healthier than the general population. They believe they got enough radiation to damage cells sufficiently to initiate the healing/growth process (the basis of exercise), but not enough to initiate the more typical negative radiation affects.